By Tiffany Lai September 21, 2023
I have worked in four different hospitals throughout my career ranging from community, trauma and county, managed care and academic hospitals. Types of hospitals This will give you a general idea of what I’ve experienced.
Work hours at a full time position
In my experience, I have not ever been required me to clock in and out at a hospital job, although you needed to a badge to get into the hospital and they are able to track that information if needed. All have expected me to work an 8 hour day plus however long I took to eat my lunch. Some had expectations for me to come to work around a certain time, usually 8am-9am. Others did not care when I came in as long as I worked 8 hours. Some had positions that allowed 10 hour work days 4 days/week so that therapists would stay later to see patients admitted in the afternoons.
Work hours as a per diem position
This is similar to hospital or skilled nursing facilities. They would call us in a few days before to work. In general, per diems did not get as much mentoring as full time staff, but the pay was about $10-15 higher per hour.
Work flow
All the hospitals I have worked in have a rehab computer room where occupational, physical and speech therapists document and chart review. Usually therapists start here in the mornings, divy up the caseload and discuss patients if needed, then head to the floors to treat.
Therapists generally determine who they will see that day and who is a priority to be seen. They also determine the needed frequency of therapy. Therapists try to stick with the same patients but can swap as needed. Therapists are free to co-treat but most hospitals prefer therapists to use a rehab aide so that the patient can have separate treatments.
On the floors, I call nursing before going into rooms. After I finish sessions, I call nursing to inform them of how the patient did and contact the doctor, case manager or social worker as needed. Sometimes they will call me to request me to work with someone or to ask me a question. Many times, patients are unavailable at the time I plan to see them and I need to reschedule. Patients may be absent because they needed a CT scan or MRI or they have procedures like dialysis or there is another discipline already working with them. I usually see 2-3 patients and document after that. In one 8 hour work day, I generally see 6-8 patients.
Productivity
Most hospitals expected me to see 6-8 patients in one day. They have different ways of measuring productivity but usually by assessing how many patients you see a day on average and looking at units. Units are every 15 min you spend with a patient in the room. In general, they were expecting 30 min to 45 min treatments per patient. All hospitals designated more units for evaluations but varied on their policies for how many units an evaluation was worth.
Annual reviews and raises
Most hospitals I have worked in have a review once a year. The rehab manager generally conducts the review together with you and there is basically a passing score or under passing score. Sometimes this doesn’t affect your raise and for some it determines the percentage raise you recieve. The academic hospital had the most rigorous review, requiring peer reviews, filling out forms for annual goals, and self-assessment. All other hospitals did not have this system. Depending on whether your hospital has a union and the policies of your union, raises may be predetermined where performance is of no consequence.
Pay structure
Most hospitals had a ladder like pay structure where your pay is based on years of experience. Some based years of experience on how long you’ve worked at their particular hospital, some based it on how long you’ve been a therapist regardless of whether it was in acute care, and some only by your acute care experience.
In the academic hospital, you could earn bonuses by doing special projects and could advance to a higher pay structure by completing a set of requirements.
Continuing education
All hospitals had paid time and money allottments for continuing education. They varied greatly in the amount. Some had allotments for per diem therapists as well. There was a lot of free seminars and training sessions in the academic and trauma hospitals. For some hospitals, they asked you to give a presentation on the course you took after you finished.
Extracurriculars
Across the board, after you’ve worked a certain place for 1+ years, they will start to assign you students. For some hospitals this was option, and for others it was not. In general, after your first year you will have a fieldwork I student and after that, fieldwork II students.
Some hospitals also had hospital improvement projects you could take on as you saw fit, things like creating patient handouts or mobility boards for RNs.